Individual
NICOLE WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4500 S LANCASTER RD, DALLAS, TX 75216-7167
(214) 857-0368
Mailing address
2730 LAKE CV, CEDAR HILL, TX 75104-8245
(662) 303-0361
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
61479
TX
Other
Enumeration date
10/30/2015
Last updated
10/30/2015
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